Provider Demographics
NPI:1225228331
Name:LYNN, ROBYN PATRICE (OTR)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:PATRICE
Last Name:LYNN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 E 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-4401
Mailing Address - Country:US
Mailing Address - Phone:303-255-4133
Mailing Address - Fax:303-452-4305
Practice Address - Street 1:2501 E 104TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-4401
Practice Address - Country:US
Practice Address - Phone:303-255-4133
Practice Address - Fax:303-452-4305
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1028780313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility